Relationship Between Fecal Microbiota Transplantation And Serum Cytokines In Ulcerative Colitis

Objects:To preliminary explore the effects of fecal microbiota transplantation(FMT) on active ulcerative colitis (UC)——the evaluation of clinical efficacy and serum levels of cytokines, and discuss the underlying immune mechanisms and clinical evaluation indices of FMT treatment.Methods:(1) Screening of donors; (2) Preparation and separation of fecal microbiota; (3) The patients with active UC who complied with the inclusion and exclusion criteria were recruited, after written informed consent, blood and stool samples were obtained, colonoscopy was performed; (4) Fecal microbiota transplantations by endoscope were performed for three times. During this period, follow-up were performed for clinical symptoms, laboratory examination and colonoscopy. Blood samples from the UC patients were collected before and after FMT (FMT1-d0, FMT2-d0, FMT3-d0), and the sera were frozen after extraction; (5) 41 serum cytokines from the UC patients were quantitatively detected using AimPlex (?)Multiple Immunoassays for Flow; (6) Statistical analysis.Results:16 active UC patients were enrolled, including 10 males and 6 females. The mean age was 37±16 years, the median duration of the disease was 2.5 years. (2) FMT treatment is effective for most (14,87.5%) UC patients, ineffective for one patient, recurrence occurred after the second FMT treatment in one case. Mayo score and endoscopic subscore, ESR of 16 UC patients were significantly decreased or reduced after FMT treatment compared with before FMT treatment (P<0.01), CRP was decreased after FMT treatment; (3) Serum concentrations of IL-1Ra, IL-6, IP-10 and ENA-78 decreased significantly after the second FMT compared with before FMT(P<0.05). Serum concentrations of MEC, VCAM-1 and G-CSF decreased significantly after the first two FMT compared with pre-FMT(P<0.05). Serum concentrations of the remaining 34 cytokines in 16 UC patients showed no significant difference between before and after FMT treatment. (4) Significantly positive correlations were found between CRP and the serum levels of IL-6 (r= 0.517. P＜0.001). IL-1Ra (r= 0.3199, P<0.05), IP-10 (r= 0.5056, P<0.001) and VCAM-1 (r= 0.2961, P <0.05). Significantly positive correlations were found between ESR and the serum levels of IL-6 (r= 0.7273, P< 0.001), IL-1Ra (r= 0.3931, P< 0.01), IP-10 (r= 0.4838, P< 0.001) and VCAM-1 (r= 0.3573, P< 0.05). Significantly positive correlations were found between Mayo score and the serum levels of IP-10 (r= 0.3173, P< 0.05) and G-CSF (r= 0.4667, P< 0.01).Conclusions:FMT is an effective and safe method for the treatment of UC. After FMT treatment, the serum levels of IL-6, IL-1Ra, ENA-78, IP-10, MEC, VCAM-1 and G-CSF decrease significantly, which suggests that FMT may play a therapeutic role in UC by regulating the immune mechanisms. Serum levels of IL-6, IL-1Ra, IP-10, VCAM-1 and G-CSF are significantly associated with UC disease activity before and after FMT, which suggests that they may be markers for assessing the effect of FMT on active UC.